WHOLE BODY MEDICAL WELLNESS LTD (NPI# 1336687771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336687771 |
| Entity Type | Organization |
| Organization Name | WHOLE BODY MEDICAL WELLNESS LTD |
| Practice Address |
402 N Plum St Pontiac IL 61764-1817 |
| Practice Telephone | 8158444631 |
| Practice Fax Number | 8158441942 |
| Mailing Telephone | 8158444631 |
| Mailing Fax Number | 8158441942 |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2017-02-06 |
| Authorized Official Name | KIM KIDNER (OWNER) |
| Authorized Official Telephone | 8158444631 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Street Address |
402 N PLUM ST |
| City | PONTIAC |
| State | IL |
| Zip Code | 61764-1817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720110224 | Ashley Nicole Fauser | Chiropractor | 402 N Plum St, Pontiac, IL 61764-1817 | 2007-03-10 |
| 1124595335 | Cheryle Diana Strother | Nurse Practitioner | 402 N Plum St, Pontiac, IL 61764-1817 | 2018-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497165211 | Barbara Kay Browning | Counselor | 310 E. Torrance Ave, Pontiac, IL 61764 | 2014-05-01 |
| 1407287121 | Institute for Human Resources of Livingston County, Il | Community/Behavioral Health | 301 E Torrance Ave, Pontiac, IL 61764 | 2013-12-05 |
| 1982031241 | Annette G Franzen | Psychologist | 700 W Lincoln St # 406, Pontiac, IL 61764 | 2013-10-02 |
| 1871739185 | Woodridge of Ponitac LLC | Assisted Living Facility | 120 North Deerfield Road, Pontiac, IL 61764 | 2008-12-17 |
| 1861601171 | William Earl Hammond | Chiropractor | 210b Ladd, Pontiac, IL 61764 | 2007-05-22 |
| 1932259983 | Amy Duffy | Counselor | 210 W Water St Ste 1, Pontiac, IL 61764 | 2007-01-11 |
| 1326123340 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 1034 W. Reynolds Street, Pontiac, IL 61764 | 2006-10-26 |
| 1205932977 | Gary Merl Leverton | Dentist | 518 West Madison St, Pontiac, IL 61764 | 2006-09-16 |
| 1891899886 | Robert E Heins | Family Medicine | 520 West Madison, Madison Street Clinic PC, Pontiac, IL 61764 | 2006-09-11 |
| 1710081708 | Kenneth N Jordan | Family Medicine | 520 West Madison Street, Madison Street Clinic PC, Pontiac, IL 61764 | 2006-09-11 |
| Find all providers in zip 61764 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962062539 | Healthcare Alliance Pllc | General Practice | 35 S Johnson St Ste 1b, Pontiac, MI 48341-1660 | 2019-06-17 |
| 1922449776 | Dr. David Basch & Dr. Alan Widlansky, Pllc Dba Dna Medical Center | General Practice | 486 W Huron St, Pontiac, MI 48341-1602 | 2013-07-09 |
| 1861765695 | Us Healthcare Mi, PC | General Practice | 461 W Huron St Ste 600, Pontiac, MI 48341-1601 | 2012-02-09 |
| 1245546415 | Express Health PC | General Practice | 461 W Huron St Ste 605, Pontiac, MI 48341-1601 | 2010-08-26 |
| 1851619464 | Rtc Enterprise, Inc. | General Practice | 1425 Giddings Rd, Pontiac, MI 48340-2111 | 2010-05-06 |
| 1407942394 | Perry Mlk Medical Center P.C. | General Practice | 673 Martin Luther King Jr Blvd N, Pontiac, MI 48342-1627 | 2006-10-05 |
| 1861409302 | Bryan K Swilley | General Practice | 673 Mlk Blvd N, Pontiac, MI 48342 | 2006-08-01 |
| 1699114926 | Samer Sami Kannab Aida | General Practice | 50 N Perry St, Pontiac, MI 48342-2217 | 2013-06-19 |
| 1922265982 | Adnan Matta Md PC | General Practice | 44555 Woodward, #106, Pontiac, MI 48341 | 2008-05-19 |
| 1598951931 | Community Bridges Management, Inc. | General Practice | 31 Oakland Ave, 1st Floor, Suite E, Pontiac, MI 48342-2019 | 2007-09-19 |
| Find all providers in PONTIAC | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.